NPIMap

Organization Active NPI

Effingham Rehab Services, LLC

Doing business as CORA Physical Therapy - Pembroke

  • Rehabilitation Clinic/Center
  • Pembroke, GA
National Provider Identifier
1790289544
Registry record updated Oct 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Clinic/CenterTaxonomy code 261QR0400X
Legal business name
EFFINGHAM REHAB SERVICES, LLC
Doing business as
CORA Physical Therapy - Pembroke
Practice address
105 E Bacon St
Pembroke, GA 31321
Phone
(912) 653-0040
Fax
(912) 653-0038
NPI assigned
Mar 19, 2018
Last updated
Oct 12, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Steve Krzyminski
Title
Exec VP
Phone
(419) 221-6717

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Clinic/Center 261QR0400X Primary

Addresses

Primary practice location

105 E Bacon St
Pembroke, GA 31321

Mailing address

PO Box 150
Lima, OH 45802-0150
Phone (419) 221-6717

Other names 1

  • CORA Physical Therapy - Pembroke Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171025001724 GA Part A Provider - Outpatient Physical Therapy/Occupational Therapy/Speech Pathology Services 5597752063 7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Pembroke, GA; Savannah, GA; Richmond Hill, GA; Pooler, GA; Hinesville, GA; Rincon, GA

Other NPIs on the same Medicare enrollment 7

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

1390 Boone Avenue Ext
Ste A23
Kingsland, GA 31548

Practitioners & affiliated clinicians

Practitioners 38

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 38

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1521417600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697068800000",
    "number": "1790289544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 150",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458020150",
            "telephone_number": "419-221-6717",
            "fax_number": "419-221-6712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 E BACON ST",
            "city": "PEMBROKE",
            "state": "GA",
            "postal_code": "31321",
            "telephone_number": "912-653-0040",
            "fax_number": "912-653-0038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EFFINGHAM REHAB SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-19",
        "last_updated": "2023-10-12",
        "certification_date": "2023-10-12",
        "status": "A",
        "authorized_official_last_name": "KRZYMINSKI",
        "authorized_official_first_name": "STEVE",
        "authorized_official_title_or_position": "EXEC VP",
        "authorized_official_telephone_number": "419-221-6717"
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CORA Physical Therapy - Pembroke",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CORA Physical Therapy - Pembroke",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pembroke, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.